Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.21 / $194.42 / $231.56	Facility		$164.21	$194.42	$231.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.56 / $184.61 / $352.29	Professional		$139.56	$184.61	$352.29
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $120.00 / $241.05 / $682.00	Professional	25	$120.00	$241.05	$682.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $165.78 / $209.22 / $265.72	Professional		$165.78	$209.22	$265.72
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $188.79 / $209.99 / $322.35	Professional	25	$188.79	$209.99	$322.35
BCBS Facility/Professional Professional Modifier Low / Median / High Price $110.90 / $184.83 / $288.68	Professional		$110.90	$184.83	$288.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $140.00 / $175.00 / $242.44	Facility		$140.00	$175.00	$242.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $180.00 / $255.63 / $368.86	Professional		$180.00	$255.63	$368.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $341.03	Professional		$32.34	$32.34	$341.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $138.19 / $206.67 / $250.45	Facility		$138.19	$206.67	$250.45
Providence Facility/Professional Professional Modifier Low / Median / High Price $172.17 / $270.63 / $465.43	Professional		$172.17	$270.63	$465.43
United Facility/Professional Professional Modifier Low / Median / High Price $215.75 / $286.64 / $411.68	Professional		$215.75	$286.64	$411.68
United Facility/Professional Professional Modifier 25 Low / Median / High Price $80.00 / $80.00 / $88.00	Professional	25	$80.00	$80.00	$88.00